Elsevier

Urology

Volume 58, Issue 2, August 2001, Pages 198-202
Urology

Adult urology
Prevalence of chronic prostatitis in men with premature ejaculation

https://doi.org/10.1016/S0090-4295(01)01151-7Get rights and content

Abstract

Objectives. To investigate the prevalence of chronic prostatitis in men with premature ejaculation. The etiology of premature ejaculation is currently considered psychological in nature. However, the possibility that urologic, hormonal, or neurologic factors may contribute to this condition should be considered in its management.

Methods. We evaluated segmented urine specimens before and after prostatic massage and expressed prostatic secretion specimens from 46 patients with premature ejaculation and 30 controls by bacteriologic localization studies. The incidence of premature ejaculation in the subjects with chronic prostatitis was also evaluated.

Results. Prostatic inflammation was found in 56.5% and chronic bacterial prostatitis in 47.8% of the subjects with premature ejaculation, respectively. When compared with the controls, these novel findings were statistically significant (P <0.05).

Conclusions. Considering the role of the prostate gland in the mechanism of ejaculation, we suggest a role for chronic prostate inflammation in the pathogenesis of some cases of premature ejaculation. Since chronic prostatitis has been found with a high frequency in men with premature ejaculation, we stress the importance of a careful examination of the prostate before any pharmacologic or psychosexual therapy for premature ejaculation.

Section snippets

Patients

A total of 46 consecutive heterosexual men aged 18 to 68 years (mean age 41.2 ± 12.3; group A, 18 to 30 years, n = 11; group B, 31 to 50 years, n = 25; and group C, 51 to 68 years, n = 12) with premature ejaculation (21 with PPE, mean age 40.1 ± 14.1 years and 25 with SPE, mean age 42.1 ± 10.7 years) were recruited from our Andrology Unit. An age-matched group of 30 healthy volunteers (age range 23 to 61 years; mean age 39.6 ± 9.3) divided into three groups of 10 men each by age (23 to 30, 31

Results

In the 46 patients with premature ejaculation, 13 (28.2%) exhibited one or more clinical symptoms of prostatitis. Twenty-six patients (56.5%) had 10 or more white blood cells per high power field in their expressed prostatic secretions; four of these patients had culture-negative results in all three specimens of urine and prostatic fluid and were considered to have nonbacterial prostatitis. The results of the microbiologic investigations showed prostatic infection in 22 (47.8%) of the 46

Comment

The results of this study demonstrated a high prevalence of chronic prostatitis in patients with premature ejaculation compared with an age-matched control group and suggest that prostatic infection and/or inflammation is a predisposing condition for premature ejaculation. According to the classification proposed by Drach et al.,24 22 of our cohort of 46 subjects demonstrated chronic bacterial prostatitis, 4 had chronic nonbacterial prostatitis, and none was affected by prostatodynia.

In early

Conclusions

If larger studies confirm our findings, a routine examination of the prostate in the clinical evaluation of patients with premature ejaculation should be performed. The bacteriologic localization test, as described by Meares and Stamey,23 even in the absence of symptoms, should be performed before considering psychosexual or pharmacologic therapies for this sexual disorder.

Acknowledgements

To Massimino D’Armiento, M.D. and Susanna Dolci, M.D. for critical reading of the manuscript; to Paola Minelli and Daniela Di Gregorio for their secretarial work; and to Rosaria Caruso, M.D. for adapting her English expertise to our needs.

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    This study was partially supported by MURST grants.

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